NPI | 1306803275 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 319) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 319) |
363A00000X Physician Assistant (Licence: ME PA2794) | |
363AM0700X Physician Assistant, Medical (Licence: ME PA2794) | |
Enumeration Date | 2006-04-26 |
Last Update Date | 2025-01-08 |