| NPI | 1740723139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1788) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MA PA5988) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2021-10-06 |