| NPI | 1356363220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA7900) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0437 P) |
| 363A00000X Physician Assistant (Licence: ME PA7900) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2019-03-11 |