| NPI | 1952079147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11272) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 0010-11272) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-02 |