| NPI | 1871621185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 0987) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2011) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA 2011) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2014-05-09 |