| NPI | 1194096834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI CPA00624) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4678) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2020-04-24 |