| NPI | 1710406012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR PA184785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 184785) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2025-04-24 |