| NPI | 1962034900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 07478) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 3315) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |