| NPI | 1841282951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA642) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA219) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2008-04-08 |