| NPI | 1447595475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0977) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016261) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2022-06-28 |