| NPI | 1821242611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2629) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0787) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2015-07-10 |