| NPI | 1780197434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1386326) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 23497) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2023-12-28 |