| NPI | 1679847610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19009) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA 10433) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |