| NPI | 1053702654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA61590289) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA p160269371) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2025-05-21 |