| NPI | 1497415061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063009) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MA063009) |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2022-12-09 |