| NPI | 1972710051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00002495) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00010323) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |