| NPI | 1912404419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 75177) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 8004) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-11-19 |