| NPI | 1285248492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1169368) |
| 363A00000X Physician Assistant (Licence: NH 1678) | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2022-10-19 |