| NPI | 1083052476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1323) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA 4701) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2024-01-31 |