| NPI | 1972606432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA626) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 201296) |
| 363A00000X Physician Assistant (Licence: RI PA00146) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2022-11-04 |