| NPI | 1164622775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0005190) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 6350) |
| Enumeration Date | 2007-07-21 |
| Last Update Date | 2015-09-22 |