| NPI | 1699121244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1819) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 5724) |
| 363AM0700X Physician Assistant, Medical (Licence: NH 1819) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2025-03-04 |