| NPI | 1740893148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10025) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: CA PA62655) | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2023-10-05 |