NPI | 1821558461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01787) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4515) |
363AM0700X Physician Assistant, Medical (Licence: CT 4515) | |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-05-13 |