| NPI | 1962711671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054585) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA MA054585) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2014-11-21 |