| NPI | 1245380559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00592) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 1397) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-01-29 |