NPI | 1043964539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 2008) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 2008) |
363AM0700X Physician Assistant, Medical (Licence: MA PA8757) | |
363AS0400X Physician Assistant, Surgical (Licence: MA PA8757) | |
Enumeration Date | 2022-02-04 |
Last Update Date | 2025-10-07 |