| NPI | 1013117761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 14108) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00019248) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2009-06-03 |