| NPI | 1558790709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1471) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA00728) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2019-07-09 |