| NPI | 1871572081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1353) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2021-01-06 |