| NPI | 1790870384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 511) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MT 511) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-07-13 |