| NPI | 1033726963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2821) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8465) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA8465) | |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2024-09-13 |