| NPI | 1013674225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT 103727) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MT 103727) | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2023-08-04 |