| NPI | 1033405451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL pta26600) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA45855) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-08-05 |