| NPI | 1801124615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0016356) |
| 101Y00000X Counselor | |
| 101YP2500X Counselor, Professional (Licence: OR LPC2773) | |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2024-02-27 |