| NPI | 1831114859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1847) | 
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: VA 0110001760) | 
| 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0110001760) | |
| 2085N0700X (Licence: VA 0110001760) | |
| 2085N0904X (Licence: VA 0110001760) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0110001760) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: VA 0110001760) | |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110001760) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0110001760) | |
| Enumeration Date | 2006-07-12 | 
| Last Update Date | 2023-12-14 |