| NPI | 1770753022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4272) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA 18146) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2011-11-29 |