| NPI | 1821002502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AL PA-472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.472) |
| 207P00000X Emergency Medicine (Licence: AL PA.472) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-02-03 |