| NPI | 1952444507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11128) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA 00020864) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2022-11-16 |