| NPI | 1780694851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 3937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0585P) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-10-13 |