| NPI | 1528501038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1543) |
| 363A00000X Physician Assistant (Licence: CA PA53999) | |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2025-09-10 |