| NPI | 1689040354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004991) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0110004991) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2023-07-28 |