| NPI | 1205358181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023008000) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2017017174) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2023-09-18 |