| NPI | 1710561352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-05-10 |