| NPI | 1932182292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0030933) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0550030353) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2014-12-04 |