| NPI | 1982997714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN PA3219) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN PT6006) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2023-12-29 |