| NPI | 1306062609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9108954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 22605) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-09-10 |