| NPI | 1235594805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059095) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA059095) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2018-03-17 |