| NPI | 1114943560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT27909) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA48609) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2019-01-17 |