| NPI | 1245234517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00080) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA245) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2023-10-24 |