| NPI | 1053651240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT112852) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-15071) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-25 |