NPI | 1568980548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 6822) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2017-08-30 |
Last Update Date | 2020-08-19 |