| NPI | 1083275325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01167) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA01167) |
| 363A00000X Physician Assistant (Licence: MA PA7338) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2021-03-08 |