| NPI | 1023373917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: UT 5484605-4701) |
| Additional Taxonomies | 171400000X (Licence: A3198092) |
| 174H00000X Health Educator (Licence: VA M.S.) | |
| 133N00000X Nutritionist (Licence: VA M.S.) | |
| 224Y00000X Clinical Exercise Physiologist (Licence: VA M.S.) | |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2023-03-12 |