| NPI | 1588043632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2015006221) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015006221) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2018-01-24 |