| NPI | 1033174438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004512) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21200) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2019-04-26 |