| NPI | 1508809815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 01373) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002078) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-03-31 |