| NPI | 1346831351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 701) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT 6101) |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2021-02-01 |