| NPI | 1205351467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: MI 57297) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501008621) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-08-09 |