| NPI | 1700229580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1078) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4623) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-11-16 |