| NPI | 1073905279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL ma 60810) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |