| NPI | 1144778192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031485) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 10094033-1206) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2023-10-11 |