| NPI | 1275305674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200002281)  | 
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 50.008496RX)  | 
| Enumeration Date | 2023-10-27 | 
| Last Update Date | 2025-10-21 |