| NPI | 1346615242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 12117) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 1668) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |