| NPI | 1285038562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00923) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2020-01-23 |