| NPI | 1689283848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6442) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT PTP-PTA-LIC-11251) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2025-04-19 |