| NPI | 1598210866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1184) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 15467) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2025-10-10 |