| NPI | 1780789925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0861) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA A10622RX) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-01-05 |