| NPI | 1023556032 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60725172) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT127611) | 
| Enumeration Date | 2017-02-09 | 
| Last Update Date | 2019-08-19 |