| NPI | 1942447974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH EL10207) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012891) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2022-09-27 |