| NPI | 1215403068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 055-0031470) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: VT 055-0031470) | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2020-09-10 |