| NPI | 1235773912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL 73597) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 29671) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |