| NPI | 1083097133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1410) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057649) |
| 363A00000X Physician Assistant (Licence: CO PA.0006670) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2021-07-15 |