| NPI | 1972627016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017228-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 006271) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2014-02-24 |