| NPI | 1972577369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00917) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9102440) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-10-24 |