NPI | 1295952430 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA110283) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA22695) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2017-07-07 |