| NPI | 1629588702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118336) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA76892) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-09-25 |