| NPI | 1225686983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060941) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA060941) |
| 207P00000X Emergency Medicine (Licence: PA OA004962) | |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-11-01 |