| NPI | 1093808636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 0050-02729) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC 24) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2009-07-01 |