| NPI | 1639493786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3870) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: RI PA00547) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2016-09-29 |