| NPI | 1790268571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23117) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M05911) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2019-03-19 |