| NPI | 1891199972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL PA9108390) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108390) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2022-06-06 |