| NPI | 1255749651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031635) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031216) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2023-01-23 |