| NPI | 1679910988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA00732) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 4703) |
| 363A00000X Physician Assistant (Licence: CT 2908) | |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-11-07 |