| NPI | 1205908068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9102718) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA9102718) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-10-23 |