| NPI | 1700235868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00877) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-09-05 |