| NPI | 1356053094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116845) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA9116845) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-03-05 |