| NPI | 1477716611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC 3167) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 19222) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2020-12-21 |