| NPI | 1992855878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103706) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2010-04-29 |