| NPI | 1548204399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00065) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA2597) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-02-16 |