| NPI | 1568648137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1282) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: SC 1282) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2022-11-28 |