| NPI | 1659578656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00010710) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00006722) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2014-12-10 |