| NPI | 1407447220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61366311) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 085.008128) |
| 363A00000X Physician Assistant (Licence: IL 085008128) | |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2023-03-06 |