| NPI | 1699904110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 002017) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IA 002017) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2021-12-02 |