| NPI | 1265941769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6892) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2019-04-03 |