| NPI | 1053635920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 301382) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA ma6038755) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2022-03-01 |