| NPI | 1174167100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01390) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 1159188) |
| Enumeration Date | 2019-11-02 |
| Last Update Date | 2021-09-13 |