| NPI | 1649942954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01844) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9161) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-11-20 |