| NPI | 1467406405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00799) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1556) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2015-05-29 |