| NPI | 1366453573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0030924) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 560) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2023-03-07 |