| NPI | 1013203298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC 4505) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 7359) |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2014-03-21 |