| NPI | 1184066110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA00842) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000889) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2015-12-17 |