| NPI | 1013930114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI 00373) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-06-03 |