| NPI | 1992997423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2523) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1100) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2020-04-22 |