| NPI | 1952642555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09874) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1608) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2020-03-19 |