| NPI | 1891166542 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2066271) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT036905) | 
| Enumeration Date | 2015-10-07 | 
| Last Update Date | 2015-10-07 |