| NPI | 1811415193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1488) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055.0031358) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2019-10-31 |