| NPI | 1558662213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200813) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 2015) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2023-04-24 |