| NPI | 1063291508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64187) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-03-12 |