| NPI | 1689153454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01075) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: RI PA01075) |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2022-05-24 |