| NPI | 1053952374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 005.0031450) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2022-10-07 |