| NPI | 1013776186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61641874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR PA222328) |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2025-01-09 |