| NPI | 1174710560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5122-23) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 3013-154) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2021-01-18 |