| NPI | 1457575896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002343) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 003267) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 002343) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-09-02 |