| NPI | 1396742649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00207) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA739) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2020-05-13 |