| NPI | 1174039952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 19441) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 08840) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2023-02-06 |