| NPI | 1699116566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AL PTA6801) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AL 3215) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |