| NPI | 1619170826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 011705) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 011705) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2016-12-15 |