| NPI | 1457843963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA01391) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6973) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2022-09-01 |