| NPI | 1568916948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1175) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031308) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2017-01-31 |