| NPI | 1457347148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA1330) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001499) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2013-03-01 |