| NPI | 1306099023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 0197511) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 001112) |
| Enumeration Date | 2008-10-25 |
| Last Update Date | 2012-02-15 |