| NPI | 1023390507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R79477) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006114) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2022-05-03 |