| NPI | 1336440585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1750) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2010035961) |
| 363A00000X Physician Assistant (Licence: MO 2018015950) | |
| 363A00000X Physician Assistant (Licence: MO 2010035961) | |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2020-04-22 |