| NPI | 1023292539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031306) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053280) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2016-08-20 |