| NPI | 1770058810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111569) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL PA9111569) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2025-11-24 |