| NPI | 1053681965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA21053) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA41431) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |