| NPI | 1821388653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006021625) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2007005872) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |