| NPI | 1548583792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0890) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3947) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2014-10-10 |