| NPI | 1417291105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA19740) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA10626) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2019-01-02 |