| NPI | 1053829796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006896) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0110-006896) |
| 363A00000X Physician Assistant (Licence: MD C0006734) | |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2020-06-19 |