| NPI | 1558469635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00415) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2179) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-09-12 |