| NPI | 1255566931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NJ 26BT00197500) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: NJ 25MT00148300) |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2010-11-08 |