| NPI | 1821543745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2029) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5846) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 004568) | |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2023-05-26 |