| NPI | 1679592067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0540) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0030581) |
| 363A00000X Physician Assistant (Licence: VT 055-0030427) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-19 |