| NPI | 1154158897 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE012327)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MS015665)  | 
| Enumeration Date | 2024-09-17 | 
| Last Update Date | 2024-09-17 |