| NPI | 1104148352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC A912) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC A912) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2023-12-13 |