| NPI | 1649270604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06721) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MP00057800) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2010-10-22 |