| NPI | 1063883866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-6057) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI MAT-14437) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2025-01-22 |