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 |