| NPI | 1477584415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 34195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3153) |
| 363A00000X Physician Assistant (Licence: VT 055-0031003) | |
| 363A00000X Physician Assistant (Licence: NH 748) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-07-22 |