| NPI | 1063676922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1037026) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT025709) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2016-11-22 |