| NPI | 1356571210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA17603) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL2168) |
| 225700000X Massage Therapist (Licence: FL MA55451) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2009-07-24 |