| NPI | 1376944249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5783) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5783) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 5783) | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2024-04-29 |