| NPI | 1598194631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200683) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2015-06-26 |