| NPI | 1215362058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 7025) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA01016) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2025-04-09 |