| NPI | 1528585379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8344) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00975) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2025-03-20 |