| NPI | 1780113993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI MAT-11713) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: HI PTA-141) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |