| NPI | 1033488218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00632)  | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical | 
| Enumeration Date | 2011-12-18 | 
| Last Update Date | 2018-01-25 |