| NPI | 1578877015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA-054457) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA 101855) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2021-05-19 |