| NPI | 1962436618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: RI PA00353) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 001774) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-09-04 |