| NPI | 1407907033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 9022) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000916) |
| 363AM0700X Physician Assistant Medical (Licence: MT MED-PAC-LIC-129466) | |
| 363AM0700X Physician Assistant Medical (Licence: VT 055.0031160) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2024-04-28 |