| NPI | 1538667159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN 12745) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2020-05-18 |