| NPI | 1679439665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502005739) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501005565) |
| Enumeration Date | 2026-01-02 |
| Last Update Date | 2026-01-02 |