| NPI | 1598517039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100676) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-05-16 |