| NPI | 1972054187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115145) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT18110) |
| Enumeration Date | 2016-10-23 |
| Last Update Date | 2021-10-12 |