| NPI | 1578023040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8031) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: AZ 8031) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-10-19 |