| NPI | 1740516400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT104684) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2083880) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2018-09-07 |