| NPI | 1922319995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA1214) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ME PA001214) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2018-03-17 |