| NPI | 1902233554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME154778) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107539) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2022-07-28 |