| NPI | 1033882808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MO 2021007117) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2012031796) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2021-07-28 |