| NPI | 1952917353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1938) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: ID PA-1938) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2023-02-10 |