| NPI | 1164838389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 7479) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 7479) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 3121) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2023-02-05 |