NPI | 1568868958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT5731) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT101355) |
Enumeration Date | 2014-11-12 |
Last Update Date | 2014-11-12 |