| NPI | 1326040973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 1317) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: IA 01493) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2026-07-20 |