| NPI | 1972829794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV PA1538) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1314) |
| 363A00000X Physician Assistant (Licence: NY 013268) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2018-10-04 |