| NPI | 1578068607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07437) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 229358) |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-08-21 |