| NPI | 1255761433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1791) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NE 19822) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2016-10-18 |