| NPI | 1073282091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA31238) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA101303) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-05-12 |