| NPI | 1851602932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA 60118660) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA P1 60073700) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |