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 |