| NPI | 1841216785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2001001417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004050) |
| 207P00000X Emergency Medicine (Licence: MO 2001001417) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-10-29 |