| NPI | 1356715189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52856) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2023-03-08 |