| NPI | 1336617802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX PA15765) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA PA57598) |
| 363A00000X Physician Assistant (Licence: CA 57598) | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2024-03-07 |