| NPI | 1639769847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113981) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL PA9113981) |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2022-05-20 |