| NPI | 1063614188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 0965) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2061) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-08-27 |