| NPI | 1639537301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116664) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-10-26 |