NPI | 1659729093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA OA60801269) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60790383) |
Enumeration Date | 2016-05-26 |
Last Update Date | 2020-05-15 |