| NPI | 1871878918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 055-0031424) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5025) |
| 363AS0400X Physician Assistant, Surgical (Licence: MA PA5008) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2023-02-07 |