| NPI | 1144392234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4137) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 2696) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-12-05 |