| NPI | 1013938992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031067) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0031067) |
| 363AM0700X Physician Assistant, Medical (Licence: CO 2244) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2021-05-28 |