| NPI | 1841284270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0030203) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 0550030203) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2010-09-14 |