| NPI | 1578224127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5316) |
| 363A00000X Physician Assistant (Licence: NC 312631) | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2024-03-27 |