| NPI | 1639273246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 0550030955) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 0550030954) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2010-06-01 |