| NPI | 1619478351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 23761) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL 63501) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |