| NPI | 1679859482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 3283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-3283) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2014-05-13 |