NPI | 1548649825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115096) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA12787) |
Enumeration Date | 2015-05-20 |
Last Update Date | 2021-10-01 |