| NPI | 1942267620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00396) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2024-06-06 |