| NPI | 1629258025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1338) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19447) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2020-02-19 |