| NPI | 1447376124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MD M05869) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD 1762) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2019-09-04 |