| NPI | 1922438811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006865) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401010189) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2019-04-12 |