| NPI | 1902155609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60280480) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA 00019510) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |