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 |