| NPI | 1093848616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00001572) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P1 60033083) |
| 225200000X Physical Therapy Assistant (Licence: OR 8487) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-11-06 |