| NPI | 1013373794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00855) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2022-03-11 |