| NPI | 1023361706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT004736) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC MAS.5562) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2016-01-17 |