| NPI | 1942740592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00940) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2021-05-20 |