| NPI | 1336446756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA160589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0031091) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2023-06-05 |