| NPI | 1295252518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059241) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0110005910) |
| 363A00000X Physician Assistant (Licence: PA OA004241) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2024-07-23 |