| NPI | 1063790368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 18322) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 1362) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2012-11-09 |