| 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 |