| NPI | 1063941367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114827) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT32592) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2025-01-14 |