| NPI | 1821391897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 1039) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT 7693) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2015-01-27 |