| NPI | 1861747644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1726) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003931) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2023-08-01 |