| NPI | 1003817578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 15527) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MP00121500) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2015-11-16 |