| NPI | 1790932358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 012706) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 018307) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2013-10-16 |