| NPI | 1821142712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA PTA001371) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: GA MT000165) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2009-05-19 |