| NPI | 1508186156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MI 5601005679) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MI 5601005679) |
| Enumeration Date | 2010-06-06 |
| Last Update Date | 2017-12-13 |