| NPI | 1144514084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20201) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 8164) |
| 225700000X Massage Therapist (Licence: MA 6854) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2015-02-05 |