| NPI | 1659650315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: RI PA00771) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA001289) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2015-12-30 |