| NPI | 1184675449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA AP2127) |
| 363A00000X Physician Assistant (Licence: NH 0349) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-02-19 |