NPI | 1083370902 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 2581) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCM103376) |
Enumeration Date | 2021-11-15 |
Last Update Date | 2025-07-15 |