| NPI | 1376550681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 719) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA A719) |
| 363A00000X Physician Assistant (Licence: PA MA003577L) | |
| 363A00000X Physician Assistant (Licence: NH 0719) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-12-14 |