| NPI | 1699000240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA001302) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3882) |
| 363A00000X Physician Assistant (Licence: NH 0879) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2012-09-06 |