NPI | 1831543024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5633) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH PA1160) |
Enumeration Date | 2016-04-14 |
Last Update Date | 2023-08-04 |