| NPI | 1073040366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR 64155) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-08-02 |