| NPI | 1063398303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066909) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MA066909) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-09-24 |