| NPI | 1790066637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60863546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003616) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C0004496) | |
| 207P00000X Emergency Medicine (Licence: NJ mp00369700) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2022-07-21 |