| NPI | 1366856056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5037) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-07-18 |