| NPI | 1730635640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: HI 136) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00067100) |
| 225700000X Massage Therapist (Licence: NJ 18KT00365100) | |
| 225700000X Massage Therapist (Licence: HI 12938) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2018-08-21 |