| NPI | 1881091353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031236) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-11-29 |
| Last Update Date | 2015-02-11 |