| NPI | 1396800520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA00489) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001873) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2010-02-05 |