| NPI | 1205347143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1803) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6320) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2024-02-19 |