| NPI | 1629452156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0031625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003828) |
| 363A00000X Physician Assistant (Licence: VA 0110-005632) | |
| 363A00000X Physician Assistant (Licence: CO 0004295) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2023-04-05 |