| NPI | 1346840972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 4322) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1502598) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: KS 1502598) | |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2022-05-02 |