| NPI | 1043676539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9494) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1146) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2023-09-24 |