| NPI | 1144221862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00145) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7524) |
| 363AS0400X Physician Assistant, Surgical (Licence: RI PA00145) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA7524) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-06-05 |