NPI | 1629476486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017821) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042351) |
Enumeration Date | 2014-12-10 |
Last Update Date | 2019-06-03 |