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 |