| NPI | 1497035208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4688) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00704) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2024-06-03 |