| NPI | 1720021918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0030993) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 0581) |
| 363AS0400X Physician Assistant, Surgical (Licence: VT 055-0031029) | |
| 363AS0400X Physician Assistant, Surgical (Licence: VT 055-0030993) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-10-30 |