| NPI | 1578228276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062964) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA062964) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2022-01-27 |