NPI | 1174649933 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114084) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 23539) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2022-10-20 |