| NPI | 1730179938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103112) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 103112) |
| 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: NC 103112) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2024-11-21 |