NPI | 1063145522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61489439) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-07-01 |
Last Update Date | 2023-12-12 |