| NPI | 1205188034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1049) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055787) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2014-10-13 |