NPI | 1770128290 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT107484) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX MT107484) |
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX MT107484) | |
Enumeration Date | 2019-11-07 |
Last Update Date | 2019-11-07 |