| NPI | 1104872845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003611) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 3041) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2011-12-08 |