| NPI | 1831549161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7663) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NH EL13736) | |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2025-06-24 |