| NPI | 1932326824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: VA 0019009348) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306601808) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2022-02-07 |