| NPI | 1770391773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA102385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01880) |
| Enumeration Date | 2024-12-21 |
| Last Update Date | 2026-02-13 |