| NPI | 1144773185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5213) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00965) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2021-06-04 |