| NPI | 1376612671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ME PA-897) |
| 363A00000X Physician Assistant (Licence: ME PA897) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2019-04-01 |