| NPI | 1700338407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA01257) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 23.003718) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2020-08-11 |