| NPI | 1770711400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1393) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AL 1458) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2019-09-08 |