| NPI | 1447635263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5478) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2019-11-04 |