| NPI | 1598006082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4582) |
| 363A00000X Physician Assistant (Licence: RI PA00672) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA056063) | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2018-03-07 |