| NPI | 1902161383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 8843) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2022-07-26 |