| NPI | 1538396023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3782) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00622) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2013-04-23 |