| NPI | 1821133935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA2422) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL PA2422) |
| 363A00000X Physician Assistant (Licence: FL PAX940) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-09-28 |