| NPI | 1740210509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA1799) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2025-04-29 |