| NPI | 1013279348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7647) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 6682A) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2019-11-13 |