| NPI | 1417322074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117973) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA12540) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2024-04-12 |