| NPI | 1316298581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031275) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015919) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2015-12-17 |