| NPI | 1710238308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8670) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9106820) |
| 363A00000X Physician Assistant (Licence: RI PA01203) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2023-10-03 |