| NPI | 1477238426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA102124) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01608) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2026-01-09 |