| NPI | 1366994915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL PTA20696) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA83575) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-11-16 |