| NPI | 1508896341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 103447) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA050789) |
| 363A00000X Physician Assistant (Licence: PA MA050789) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-01-07 |