| NPI | 1437414141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031235) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0984) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2019-01-21 |