| NPI | 1861057010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024132) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055.0031447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2020-01-13 |