| NPI | 1629257324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA25872)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 51723)  | 
| Enumeration Date | 2007-10-30 | 
| Last Update Date | 2015-09-04 |