NPI | 1003359431 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT128058) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT4772) |
Enumeration Date | 2016-12-03 |
Last Update Date | 2024-02-02 |