| NPI | 1497202212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NC 12489) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC A5970) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2023-03-23 |