| NPI | 1164661583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA 199) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |