| NPI | 1275918286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3383) |
| 363A00000X Physician Assistant (Licence: MA PA5430) | |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2023-07-10 |