| NPI | 1053926543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL 54045) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 019474-1) |
| 225700000X Massage Therapist (Licence: NJ 18KT00961600) | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |