| NPI | 1326642000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2852) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028568) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2024-09-24 |