| NPI | 1285890582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061592) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA061592) |
| 225700000X Massage Therapist | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2021-01-11 |