| NPI | 1407376528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT015636) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA pta003828) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-11-10 |