| NPI | 1205081387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA23309) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: DE MT-0002630) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2012-09-17 |