| NPI | 1841411535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0573) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA-367) |
| 174400000X Specialist (Licence: NH 0573) | |
| 174400000X Specialist (Licence: MA 150) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-06-05 |