| NPI | 1063736445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: VA 0019008505) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WV 2009-2618) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2022-07-15 |