| NPI | 1699765057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2333) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0030836) |
| 363A00000X Physician Assistant (Licence: NH 0569) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-12-08 |