| NPI | 1346370491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: UT 10682211-1204) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2002-0038) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-10-21 |