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 |