| NPI | 1205301249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111710) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9111710) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2020-01-28 |