| NPI | 1861790511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 0813) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 0813) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2012-01-13 |