| NPI | 1558466540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5184) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00253) |
| 363A00000X Physician Assistant (Licence: FL 9118309) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2026-01-06 |