| NPI | 1871960971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005073) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0110005073) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2019-01-11 |