| NPI | 1669587754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WV 000951) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WV 2004-1442) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |