| NPI | 1770954562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P160887513) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 16072) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2020-05-11 |