| NPI | 1558898759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181738) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2023-01-16 |