| NPI | 1114242807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3956) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2020-07-22 |