| NPI | 1144786807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 5971575) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2001) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2025-09-22 |