| NPI | 1275558652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA00441) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1215) |
| 363A00000X Physician Assistant (Licence: MA 4181) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-01-31 |