| NPI | 1649316795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 15313) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA217) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-02-05 |