| NPI | 1265440861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 55-0030351) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: VT 55-0030351) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-10-04 |