| NPI | 1396054128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01131) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4033) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2021-04-05 |