| NPI | 1912104118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051742) |
| Additional Taxonomies | 364SE0003X Clinical Nurse Specialist, Emergency (Licence: PA MA051742) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-02-16 |