| NPI | 1538750211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL PA9113980) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9113980) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2023-04-07 |