| NPI | 1417135559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1855) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 7197) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2009-05-07 |