| NPI | 1003232612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1552) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4953) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2021-11-15 |