| NPI | 1790093730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61505595) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C006993) |
| 363A00000X Physician Assistant (Licence: NC 0010-13458) | |
| 1041C0700X Social Worker, Clinical (Licence: WA 61505595) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2025-11-18 |