| NPI | 1417612227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A5249) |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2024-09-16 |