| NPI | 1255342069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MT MED-PAC-LIC-69431) |
| Additional Taxonomies | 2084P0805X (Licence: MT MED-PAC-LIC-69431) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-03-07 |