| NPI | 1073067237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA000907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5804) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2023-06-22 |