| NPI | 1699171694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC PA2406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00784) |
| 363A00000X Physician Assistant (Licence: SC PA2406) | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2024-05-13 |