| NPI | 1356536874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5460) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00248) |
| 363AM0700X Physician Assistant, Medical (Licence: RI PA00248) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2024-01-12 |