| NPI | 1922745751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL pta29516) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA72585) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2022-05-13 |