| NPI | 1982695615 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 2601)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59918)  | 
| Enumeration Date | 2005-11-02 | 
| Last Update Date | 2022-11-09 |