| NPI | 1982866612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2052768) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |