| NPI | 1578761813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA32076) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA19513) |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2008-06-13 |