| NPI | 1477826071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT007357) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: SC 9071) |
| 171000000X Military Health Care Provider (Licence: SC 9071) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: SC Mas.9071) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: SC 9071) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 90071) | |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2024-05-10 |