| NPI | 1821229790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 09549) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL ma43555) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2019-02-25 |