| NPI | 1578625331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 000988) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: GA RN026508) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2011-09-09 |