| NPI | 1194225490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07912) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 0010-07912.) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-03-12 |