| NPI | 1780086488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4280) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10184) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2025-09-09 |