| NPI | 1194393405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 9774) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2025-10-23 |