| NPI | 1306032529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102342) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 993) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 102342) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2023-07-13 |