| NPI | 1831583319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 00515) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IA 04291) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-24 |