| NPI | 1417250424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO MT.0015599) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO PTA.0012283) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2016-04-19 |