| NPI | 1245769538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: HI PTA-192) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI MAT-14701) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |