| NPI | 1558501338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2030575)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT029946)  | 
| Enumeration Date | 2009-03-06 | 
| Last Update Date | 2009-03-06 |