| NPI | 1770191009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01255) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 7639) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2023-03-03 |