| NPI | 1821863069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101919) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 3534) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2025-09-04 |