| NPI | 1790921633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0707) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2645) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2022-01-25 |