| NPI | 1982687117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 0010-08044) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051324) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2018-10-03 |