| NPI | 1174025134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010386) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9118930) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2024-11-11 |