| NPI | 1548735525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD 1156633) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD 1156633) |
| 363A00000X Physician Assistant (Licence: 1156633) | |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2021-11-25 |