| NPI | 1770914848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA64758) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA24639) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2014-01-06 |