| NPI | 1326142423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0667) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0030785) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2008-05-16 |