| NPI | 1710403456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64137) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID 2998) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2024-12-11 |