| NPI | 1669787941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1534) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 52998) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2019-12-18 |