| NPI | 1043853963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MA 15821) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 005524) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2024-01-12 |