| NPI | 1235142795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001220) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0110001220) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-01-06 |