| NPI | 1831320159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA300) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0972) |
| 363A00000X Physician Assistant (Licence: ME PAN300) | |
| 363A00000X Physician Assistant (Licence: ME PA300) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2022-06-09 |