| NPI | 1336464510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1423) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013951) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2014-12-01 |