| NPI | 1104332758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG014512) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE1004488) |
| 225700000X Massage Therapist (Licence: MSG014512) | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2024-03-25 |