| NPI | 1568554921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME PA760) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-10-04 |