| NPI | 1508376799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PAN1701) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2020-10-05 |