| NPI | 1184930836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7655) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2020-09-11 |