| NPI | 1205469178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09801) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 0010-09801) |
| 363AM0700X Physician Assistant, Medical | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-09801) | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2024-06-10 |