| NPI | 1699753327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4915) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3677) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2014-02-12 |