| NPI | 1306476759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9115984) |
| 207P00000X Emergency Medicine (Licence: NC 0010-9729) | |
| 363A00000X Physician Assistant (Licence: NC 0010-9729) | |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2023-03-13 |