| NPI | 1104938307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT17999) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA30720) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-03-25 |