| NPI | 1588958144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA#33642) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA14269) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |