| NPI | 1134625643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NC 001007973) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07973) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-09-17 |