| NPI | 1285194290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01139) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7007) | 
| Enumeration Date | 2019-03-25 | 
| Last Update Date | 2025-08-22 |