| NPI | 1548784325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00990) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6268) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2021-11-03 |