| NPI | 1538838974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11165) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: SC 4108) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2022-09-16 |