| NPI | 1356077135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9390) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 2034) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-05-29 |