| NPI | 1073030441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PR 718) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC MAS8027) |
| 225700000X Massage Therapist (Licence: GA MT010105) | |
| 225700000X Massage Therapist (Licence: FL MA68855) | |
| Enumeration Date | 2017-08-27 |
| Last Update Date | 2020-11-05 |