| NPI | 1336424092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA 60253261) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA p1 60045652) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2013-03-01 |