| NPI | 1740855865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA91114783) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9114783) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-12-14 |