| NPI | 1396147443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA100078) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1043) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2024-01-26 |