| NPI | 1114054749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 111701) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA14708) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2024-10-13 |