| NPI | 1336353861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC PA1055) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 1055) |
| 363AM0700X Physician Assistant Medical (Licence: SC SC1055) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2022-01-13 |