| NPI | 1558839043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 0550031467) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2421) |
| 363A00000X Physician Assistant (Licence: NH 1947) | |
| 363AM0700X Physician Assistant, Medical (Licence: NY 023278) | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2023-09-12 |