| NPI | 1215196894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA064256) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2023-02-23 |