| NPI | 1083190524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502005636) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501000205) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |