| NPI | 1073521472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC009833) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA AJ009646) |
| 363A00000X Physician Assistant (Licence: MD C0005522) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA001679L) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA 3037) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-09-10 |