| NPI | 1457486805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10279349) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 7615) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2021-06-09 |