| NPI | 1982019576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1336) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-11-03 |