| NPI | 1699895060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9100896) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: FL PA9100896) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-10-14 |