| NPI | 1922298470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA001092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1784) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2022-08-23 |