| NPI | 1427104181 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL PA9104017)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104017)  | 
| Enumeration Date | 2007-01-26 | 
| Last Update Date | 2012-11-07 |