| NPI | 1376978825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR PA164846) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: OR PA164846) |
| 363A00000X Physician Assistant (Licence: OR PA164846) | |
| 363AM0700X Physician Assistant Medical (Licence: OR PA164846) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2024-08-08 |