| NPI | 1649513433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1527) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4690) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2016-04-12 |