| NPI | 1801379565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 18-0416) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WA ATHL.A1.60875168) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |