| NPI | 1174147698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063521) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: RI PAO1232) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2024-01-30 |