| NPI | 1033874961 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT013781) | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN083096) | 
| Enumeration Date | 2021-11-04 | 
| Last Update Date | 2021-11-04 |