| NPI | 1821490921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031347) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018126) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2018-01-31 |