| NPI | 1407240609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 2287-19) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WI 3804-146) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |