| 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 |