| NPI | 1104861566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0002296) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD C0002296) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2007-08-10 |