| NPI | 1215623871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT210002208) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: DC MT2596) |
| 225700000X Massage Therapist (Licence: VA 0019017719) | |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-06-12 |