| NPI | 1760731970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C7-0006772) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004827) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2018-06-04 |