| NPI | 1902874647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA3042) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-05-22 |