| NPI | 1073025441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059519) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2022-02-10 |