| NPI | 1114040250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NM A317) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NM NM 3955) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2025-09-11 |