NPI | 1013590462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110007916) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0110007916) |
Enumeration Date | 2021-05-04 |
Last Update Date | 2024-07-19 |