| NPI | 1356994313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA060789) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2022-05-04 |