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 |