| NPI | 1417487455 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 090207) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 2800) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2021-04-28 |