| NPI | 1043431687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: NC 7908) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 020420-1) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2015-01-26 |