| NPI | 1740592617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 0550031179) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA100218) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2024-02-20 |