| NPI | 1033391461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0031526) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0268) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2022-03-01 |