| NPI | 1932450939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2015-06-16 |