| NPI | 1790026664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CA 1349) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI 6392) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2013-03-01 |