| NPI | 1023387842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008547) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: GA MT003325) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |