| NPI | 1144309303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 0550031408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102912) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-02-06 |