| NPI | 1124274378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 002126) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA00473) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2014-10-30 |