| NPI | 1710175385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2313) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VT 0550030864) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2024-10-11 |