| NPI | 1780930842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101276) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00652) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2026-01-14 |