| NPI | 1316051030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 002234) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: GA 10875901) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 002234) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-02-01 |