| NPI | 1801262225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE1004626) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG001163) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2017-03-17 |