| NPI | 1912363128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MA 9063) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA 7178) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |