| NPI | 1184040982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11551-33) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2038-19) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2022-03-07 |