| NPI | 1932361813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WI 15556-146) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1584-19) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2021-09-01 |