NPI | 1255945564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX PA13718) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13718) |
Enumeration Date | 2020-09-03 |
Last Update Date | 2023-03-15 |