| NPI | 1134403439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5086) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI 00607) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2024-01-12 |