| NPI | 1952561458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA 60303757) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 6393A) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2013-08-09 |