NPI | 1578686622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4475) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.011396) |
Enumeration Date | 2007-04-06 |
Last Update Date | 2018-08-06 |