| NPI | 1326525270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: RI PA01436) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 022166) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2025-03-28 |