| NPI | 1740308352 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NE 3253) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 758) | 
| Enumeration Date | 2007-03-26 | 
| Last Update Date | 2024-12-03 |