| NPI | 1487812780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1429) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA1005) |
| 363AM0700X Physician Assistant, Medical (Licence: MA 1005) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2021-09-30 |