| NPI | 1508089871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: RI PA00400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00400) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-03-17 |