| NPI | 1033439393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA PC015931) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical (Licence: PA MA060368) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2025-04-17 |