| NPI | 1659651586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 001007838) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 16684) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2018-03-17 |