| NPI | 1689667164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10001045A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-821) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2022-06-23 |