| NPI | 1972154771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7629) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 7629) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2024-07-16 |