NPI | 1811921372 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9106151) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW 6735) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2025-09-17 |