| NPI | 1164582771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WI 724-146) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1353-019) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-08-18 |