| NPI | 1265669287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 1259) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1280) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2024-12-16 |