| NPI | 1821344748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00655) |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2017-03-13 |