| NPI | 1033775580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG012750) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 010794-1) |
| 225200000X Physical Therapy Assistant (Licence: PA TEI004449) | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-06-08 |