| NPI | 1073180550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 005264) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5264) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 5264) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2022-10-31 |