| NPI | 1033632112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08993) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 54510) |
| 363A00000X Physician Assistant (Licence: CA 54510) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2024-02-04 |