| NPI | 1770093221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 6937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6937) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2019-07-16 |