| NPI | 1770677510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001527) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0110001527) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-07-20 |