| NPI | 1891017679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO 5043) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CO 11624) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2012-03-21 |