| NPI | 1093136129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: MD M055859) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MT 4132) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2022-08-13 |