| NPI | 1992863179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1170) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 7355) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2019-08-26 |