| NPI | 1760702351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 27523) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA57303) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2019-07-08 |