| NPI | 1619640497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA5437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 0550031520) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2024-11-14 |