| NPI | 1497884787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00021) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2433) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-11-13 |