| 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 |