| NPI | 1821405366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1155) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5061) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2020-09-18 |