| NPI | 1528661402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 0010-12713) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: VA 0110007938) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2023-03-15 |