| NPI | 1194019364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: TX MT112219) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT112219) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-13 |