| NPI | 1831500420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119501) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA22412) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2025-01-17 |