| NPI | 1619387669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MD 44946) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD 185123) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2020-01-14 |