| NPI | 1891975827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME PA001109) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME PA1109) |
| 363A00000X Physician Assistant (Licence: ME PA001109) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2018-09-06 |