| NPI | 1538340641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-06963) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 363A00000X Physician Assistant (Licence: NC 0010-06963) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2021-02-02 |