| NPI | 1750863403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA61007880) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: WA OT00001179) |
| 225XP0200X Occupational Therapist Pediatrics (Licence: WA OT00001179) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2019-12-14 |