| NPI | 1013504976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01302) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5181) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2023-02-28 |