NPI | 1366030355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX PA16176) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX PA16176) | |
Enumeration Date | 2021-01-05 |
Last Update Date | 2024-06-14 |