NPI | 1679982862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1646) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 10989) |
363A00000X Physician Assistant (Licence: NH PA1890) | |
363A00000X Physician Assistant (Licence: MA PA8967) | |
Enumeration Date | 2014-08-13 |
Last Update Date | 2023-12-28 |