| NPI | 1356377485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010958-1) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2010-02-16 |