| NPI | 1477550234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4937) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00171) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-04-24 |