NPI | 1760601587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53253) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD 35) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2019-02-04 |