| NPI | 1598162935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056996) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA MA056996) |
| 207P00000X Emergency Medicine (Licence: PA MA056996) | |
| 207Q00000X Family Medicine (Licence: PA MA056996) | |
| 207R00000X Internal Medicine (Licence: PA MA056996) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2016-02-05 |