| NPI | 1972032902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG003803) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE009936) |
| 225200000X Physical Therapy Assistant (Licence: WV PTA002036) | |
| Enumeration Date | 2017-06-04 |
| Last Update Date | 2017-06-04 |