| NPI | 1265064901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 10189) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 024474) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2021-02-16 |