| NPI | 1134413735 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115417) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI AMD-613) | 
| 363A00000X Physician Assistant (Licence: MN 1098258) | |
| Enumeration Date | 2011-06-01 | 
| Last Update Date | 2022-03-10 |