| NPI | 1053693093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA ma00021275) |
| Additional Taxonomies | 171W00000X Contractor (Licence: WA ma00021275) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2022-12-05 |