| NPI | 1215407473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 10021) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2022-01-11 |