| NPI | 1891565172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA 61368535) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WA 60575719) |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |