| NPI | 1902058902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AK 1582) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AK 101226) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2020-05-19 |