| NPI | 1194022798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN 7130) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 4521) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2017-01-24 |