| NPI | 1619032349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 005162) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT001332) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-10-03 |