| NPI | 1063780963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 18269) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60254331) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2013-01-24 |