| NPI | 1588688550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1012870) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT039069) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |