| NPI | 1225576853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7160) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1242) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2019-10-14 |