| NPI | 1295383826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7864) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1514) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2024-11-21 |