| NPI | 1003847302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD c07180) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9105278) |
| 363AM0700X Physician Assistant, Medical (Licence: GA PA458) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-08-06 |