| NPI | 1972933406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: RI PA01181) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL 9107953) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2023-02-21 |