| NPI | 1003042060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2818) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01346) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2024-07-25 |