| NPI | 1710406178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306604864) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019012213) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2017-09-15 |