| NPI | 1528184116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 013624) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 13066) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2013-07-16 |