NPI | 1417196577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1152) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA001152) |
Enumeration Date | 2009-02-13 |
Last Update Date | 2024-04-04 |