| NPI | 1184943995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60987901) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 05682) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2024-12-03 |