| NPI | 1548544224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60726547) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA 00018196) |
| 363AM0700X Physician Assistant, Medical (Licence: WA 60726547) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2024-06-07 |