| NPI | 1811476070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1771) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 6667) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2022-06-29 |