| NPI | 1225285430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00472) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2016-11-17 |