| NPI | 1366513574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MA 1413) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: MA PA1413) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2025-06-30 |