| NPI | 1821403163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01039) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 074544) |
| 363A00000X Physician Assistant (Licence: MA PA8082) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-05-12 |