| NPI | 1588420921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: 085010598) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO PA.0008329) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-11-04 |