| NPI | 1306297551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009456) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210195) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-09-21 |