| NPI | 1427344795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1736) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003603) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2017-10-03 |