| NPI | 1770998692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00765) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5729) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2020-04-23 |