| NPI | 1164991402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20565) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60865226) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2021-07-19 |