| NPI | 1710113006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2012005493) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2008022940) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2017-09-18 |