| NPI | 1043855620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA 61131314) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 031214) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2021-09-27 |