| NPI | 1497148894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7756-23) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX PA09691) |
| 363A00000X Physician Assistant (Licence: TX PA09691) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2024-02-05 |