| NPI | 1487882007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT293508) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00023020) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2023-10-25 |