| NPI | 1518969377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA113264) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA9113264) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA ma051342) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2023-03-07 |