| NPI | 1902299548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0031488) |
| 363A00000X Physician Assistant (Licence: NY 026534) | |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2021-04-19 |