| NPI | 1073150405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: MD EO1465) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M05663) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2021-08-18 |