| NPI | 1891267779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01677) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60923118) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2024-07-30 |