| NPI | 1750307690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001514) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005805) |
| 363A00000X Physician Assistant (Licence: NJ MP634) | |
| 207P00000X Emergency Medicine (Licence: VA 0110001514) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-12-13 |