| NPI | 1467759886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WI 14356-146) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 70119) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2019-04-30 |