| NPI | 1992064489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031131) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NH 1941) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-05-12 |