| NPI | 1861425266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3700) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 0516) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-03-24 |