| NPI | 1184391435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031608) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026909) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2022-09-01 |