| NPI | 1215992532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1402) |
| 363AM0700X Physician Assistant Medical (Licence: MA 1402) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-04-03 |