| NPI | 1578772281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022714) |
| 363A00000X Physician Assistant (Licence: NV PA929) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-03-23 |