| NPI | 1447200894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 1427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI 00275) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-06-19 |