| NPI | 1497001069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031311) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015815) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2018-03-17 |