| NPI | 1164617791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA919) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-26013) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2024-06-25 |