| NPI | 1558914572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 2900) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2025-02-04 |