| NPI | 1922172121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00163000) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2011-07-22 |