| NPI | 1891397543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025921) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC 13315) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2025-06-19 |