| NPI | 1245992023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8343) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01407) |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2025-12-03 |