| NPI | 1730439746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1397) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4474) |
| 363A00000X Physician Assistant (Licence: ME PA329) | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2017-04-25 |