| NPI | 1467038901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8340) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01417) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-05-02 |