NPI | 1578867644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003489) |
Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0110003489) |
Enumeration Date | 2011-01-05 |
Last Update Date | 2018-12-06 |