| NPI | 1396718144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA05399) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1096725) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-04-20 |