| NPI | 1952549214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 15592) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA38316) |
| Enumeration Date | 2009-01-25 |
| Last Update Date | 2016-09-19 |