| NPI | 1841672037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60947805) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2022-08-03 |