| NPI | 1942613443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01291) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05921) |
| 363AM0700X Physician Assistant Medical (Licence: RI PA01291) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-03-31 |