NPI | 1144320227 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 1946) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3052) |
Enumeration Date | 2006-09-25 |
Last Update Date | 2008-12-24 |