| NPI | 1780763524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 101575) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME PA-442) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-05-05 |