| NPI | 1760677322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 005146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 001615) |
| 207P00000X Emergency Medicine (Licence: GA 1615) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2020-09-30 |