| NPI | 1265808745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7939-23) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13159-24) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2024-06-18 |