| NPI | 1386148468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA059725) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA059725) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-09-23 |