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 |