NPI | 1255725842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8142) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2014034082) |
Enumeration Date | 2015-03-23 |
Last Update Date | 2022-12-22 |