| NPI | 1508143892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA22148) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA40455) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2023-05-19 |