NPI | 1730293424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00713) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051330) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2014-05-12 |