| NPI | 1174276489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10826) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 10826) |
| 207P00000X Emergency Medicine (Licence: GA 10826) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-02-14 |