| NPI | 1952683542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MT 1096) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MT 568) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |