| NPI | 1861584658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2006029256) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2019029196) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-10-04 |