| NPI | 1639101322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 0515) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA AP2136) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-11-07 |