| NPI | 1053477240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 019141) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 008642-1) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2013-03-15 |