| NPI | 1063827699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NE 3343) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 1050) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2018-05-11 |