| NPI | 1497837413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-172219) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 377934-2401) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2026-03-31 |