| NPI | 1689275455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01666) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7731) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2024-04-09 |