| NPI | 1447897020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA8503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01201) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2024-06-06 |