| NPI | 1548544646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MI 7501004675) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502002850) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2017-02-16 |