| NPI | 1790324044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01743) |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2025-09-30 |