| NPI | 1790368447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MT PTP-PTA-LIC-19447) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MT MASS-15880) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2024-12-10 |